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General NPI Number Information
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NPI Number | 1760004493
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Entity Type | Organization
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Legal Business Name | LARK HOME CARE, LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 12500 BARKER CYPRESS RD APT 10307
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City | CYPRESS
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State | TX
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Zip | 77429-8268
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Country | US
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Telephone | 586-846-7103
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Fax | 586-477-4687
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Provider Business Mailing Address
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Address Line | 12500 BARKER CYPRESS RD APT 10307
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City | CYPRESS
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State | TX
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Zip | 77429-8268
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Country | US
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Telephone | 586-846-7103
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Fax | 586-477-4687
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Authorized Official
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Title or Position | OWNER
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Name | ASHLII WILLIAMS
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Credential |
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Telephone | 586-846-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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